Understanding Rural and Deep Rural America · RHTP-01.TD4
Data Tables
Geography and Rural Definition
Geography and Rural Definition#
Rural America at a Glance#
| Metric | Value | Source |
|---|---|---|
| Total nonmetro population | 46.2 million (July 2024) | USDA ERS |
| Share of U.S. population | 14% | USDA ERS |
| Share of U.S. land area | 72% | USDA ERS |
| Number of nonmetro counties | 1,958 | USDA ERS |
| Counties experiencing population loss (2020-2024) | 51% of nonmetro counties | USDA ERS |
USDA Rural Classifications#
| Classification System | Categories | Purpose |
|---|---|---|
| Rural-Urban Continuum Codes (Beale Codes) | RUCC 1-9 scale | Measure metro influence on nonmetro counties |
| Urban Influence Codes | 12 categories | Assess urban influence on nonmetro counties |
| Frontier and Remote Area (FAR) Codes | 4 levels | Identify extremely isolated areas |
| Food Access Research Atlas | Low access tracts | Identify food deserts |
Distance Thresholds for “Rural” Definitions#
| Definition Context | Urban Distance | Rural Distance |
|---|---|---|
| Food Desert (USDA) | >1 mile to supermarket | >10 miles to supermarket |
| Low Access (USDA) | >0.5 miles to grocery | >10 miles to grocery |
| Health Professional Shortage Area | Varies by service | Often >30 miles to specialist |
Demographics#
Population Characteristics#
| Characteristic | Rural (Nonmetro) | Urban (Metro) | Gap |
|---|---|---|---|
| Population (2024) | 46.2 million | ~290 million | - |
| Share of U.S. population | 14% | 86% | - |
| Median age | Higher | Lower | ~5-7 years |
| Population growth (2020-2024) | ~1% | ~2.6% | -1.6 pts |
Population Change Dynamics (2020-2024)#
| Factor | Impact on Nonmetro Population |
|---|---|
| Natural change (births minus deaths) | -563,550 people |
| Net migration (all sources) | +974,379 people |
| Domestic migration share | 69% of net migration |
| International migration share | 31% of net migration |
| Counties with natural decrease (2023-2024) | 76% (1,492 counties) |
Racial/Ethnic Composition (Nonmetro)#
| Group | Approximate Share | Notable Concentrations |
|---|---|---|
| White, non-Hispanic | ~79% | Most regions |
| Hispanic/Latino | ~9% | Southwest, meatpacking towns |
| Black/African American | ~8% | Rural South, Mississippi Delta |
| American Indian/Alaska Native | ~2% | Reservations, tribal lands |
| Asian | ~1% | Selected agricultural areas |
| Other/Multiracial | ~1% | Varies |
Migration Patterns#
| Migration Type | Trend (Post-2020) |
|---|---|
| Out-migration of young adults (18-34) | Continuing |
| In-migration of retirees | Increasing |
| Remote worker in-migration | Increased post-COVID |
| International immigration | Offsetting domestic losses |
| Counties with positive net migration (2020-2024) | 65% |
Education and Literacy#
Educational Attainment (Adults 25+)#
| Education Level | Rural (Nonmetro) | Urban (Metro) | Gap |
|---|---|---|---|
| Less than high school | 11.1% | - | - |
| High school diploma (highest) | 34% | ~25% | +9 pts |
| Some college/Associate degree | 31% | 28% | +3 pts |
| Bachelor’s degree or higher | 23% | 36% | -13 pts |
| Graduate/Professional degree | 8.3% | ~14% | -5.7 pts |
Educational Attainment Trends (2000-2023)#
| Metric | 2000 | 2023 | Change |
|---|---|---|---|
| Nonmetro adults with bachelor’s+ | 15% | 23% | +8 pts |
| Metro adults with bachelor’s+ | 26% | 38% | +12 pts |
| Rural-urban gap (bachelor’s+) | 11 pts | 15 pts | Widening |
College Enrollment (Young Adults 18-24)#
| Location | College Enrollment Rate |
|---|---|
| Rural areas | 29% |
| Suburban areas | 42% |
| Urban areas | 48% |
| Rural-Urban gap | -19 percentage points |
Earnings by Education (2023)#
| Education Level | Nonmetro Median | Metro Median | Gap |
|---|---|---|---|
| Less than high school | $31,519 | $31,675 | ~$0 |
| High school diploma | $38,000 (est.) | $42,000 (est.) | -$4,000 |
| Bachelor’s degree | $52,837 | $65,000+ | -$12,000+ |
| Overall median earnings | $42,407 | $52,109 | -$9,702 |
Economics and Employment#
Employment by Industry (Nonmetro)#
| Industry Sector | Share of Rural Counties | Population Share |
|---|---|---|
| Farming-dependent | ~20% | ~6% |
| Mining-dependent | ~5% | Varies |
| Manufacturing-dependent | ~18% | ~22% |
| Recreation/Tourism | Growing | Varies |
| Healthcare (often largest employer) | Most counties | - |
Income Comparison#
| Metric | Rural (Nonmetro) | Urban (Metro) | Difference |
|---|---|---|---|
| Median household income | ~$52,000 | ~$58,000 | -$6,000 |
| Households income <$50,000 | 39.5% | 32.5% | +7 pts |
Regional Income Variations#
| Region | Rural Median HH Income | Urban Median HH Income |
|---|---|---|
| Northeast | $62,291 | $60,655 |
| Midwest | $55,704 | $51,266 |
| South | $46,891 | $50,989 |
| West | $56,061 | $58,545 |
Poverty Rates#
| Metric | Rural (Nonmetro) | Urban (Metro) | Gap |
|---|---|---|---|
| Overall poverty rate (2023) | 15.4% | ~12% | +3.4 pts |
| Child poverty | Higher | Lower | Varies |
| Persistent poverty counties | Concentrated in South | Fewer | - |
High-Poverty Regions#
| Region | Characteristics |
|---|---|
| Mississippi Delta | Persistent poverty, agricultural legacy |
| Appalachia | Former coal communities, economic transition |
| Native American Reservations | Highest poverty rates nationally |
| Rural Southwest | Border communities, limited infrastructure |
| Black Belt South | Historical plantation economy |
Healthcare Access#
Healthcare Infrastructure#
| Metric | Rural Status |
|---|---|
| Rural hospitals (community, 2023) | 1,796 (92% of rural hospitals) |
| Rural hospital closures (2005-2024) | 193 closures |
| Closures (2017-2024) | 62 closures vs. 10 openings |
| Hospitals at risk of closure | 700+ (>30% of rural hospitals) |
| Hospitals at immediate risk (2-3 years) | 360 |
| Rural hospitals stopping OB services (2011-2023) | 293 (24% of rural OB units) |
Provider Shortages#
| Metric | Rural Status |
|---|---|
| Healthcare Professional Shortage Areas (HPSAs) in rural | >60% of all HPSAs |
| Rural counties with primary care shortage | 91% |
| Physicians practicing in rural areas | 10% (serving 14% of population) |
| Distance impact from hospital closure | +20 miles average for common services |
| Distance impact for substance treatment | +40 miles average |
Insurance Coverage Impact#
| Factor | Impact on Rural Hospitals |
|---|---|
| Closures in non-Medicaid expansion states | 69% of closures (2014-2024) |
| Rural emergency hospital conversions (2023-2024) | 37 hospitals |
Impact of Hospital Closures#
| Impact Area | Effect |
|---|---|
| Residents losing 15-minute hospital access | 812,314+ people |
| Economic impact | Increased unemployment, lower income |
| Health outcomes | Higher mortality from time-sensitive conditions |
Food and Nutrition#
Food Insecurity#
| Metric | Rural | Urban | Suburban |
|---|---|---|---|
| Food insecurity rate (2023) | 15.4% | 15.9% | 11.7% |
| Change from 2022 | +0.7 pts | - | - |
| Counties with high food insecurity that are rural | 90% | - | - |
| High food insecurity counties in South | 80% | - | - |
Food Deserts#
| Metric | Definition/Value |
|---|---|
| Urban food desert threshold | >1 mile to large grocery store |
| Rural food desert threshold | >10 miles to large grocery store |
| People in food deserts (2017) | 19 million |
| People in low-income, low-access areas | 39.5 million (12.8% of population) |
| Number of food desert census tracts | ~6,500 |
SNAP and Food Assistance#
| Metric | Rural Status |
|---|---|
| SNAP participation rate | Higher in rural areas |
| Child poverty reduction from SNAP | Especially effective in rural areas |
| Food insecure population not SNAP-eligible | ~50% (income restrictions) |
The Agricultural Paradox#
| Metric | Value |
|---|---|
| Rural counties that are farming-dependent | ~20% |
| Food insecurity in farming communities | Persistently high |
| Meal cost variation by county | $2.91 to $6.67 |
Social Fabric and Isolation#
Broadband Access#
| Metric | Rural | Urban | Tribal |
|---|---|---|---|
| Lack fixed broadband (100/20 Mbps) | 28% | ~5% | 23% |
| Americans lacking broadband access | 24-45 million (varies by definition) | ||
| Households without vehicle & far from store | 4% nationally | - | - |
Digital Divide Details#
| Metric | Value |
|---|---|
| U.S. households with broadband access (2024) | 94% |
| Rural households at broadband speeds (100/20) | 68-72% (varies by state) |
| Speed gap (urban vs rural) growing | 32 states (2024) |
| Federal broadband investment (IIJA) | $65 billion |
| BEAD Program allocation | $42+ billion |
Social Connectivity Challenges#
| Factor | Rural Impact |
|---|---|
| Social isolation/loneliness | Higher rates |
| Distance to community services | Greater |
| Multi-generational households | More common |
| Grandparents as caregivers | Higher rates |
Transportation and Mobility#
Transportation Infrastructure#
| Metric | Rural Status |
|---|---|
| Households without vehicle access | Lower than urban overall |
| Public transit availability | Severely limited |
| Distance to essential services | Significantly greater |
| Impact of lacking transportation | Limits healthcare, food, employment access |
Distance to Services#
| Service Type | Typical Rural Distance |
|---|---|
| Hospital (after closure) | +20 miles additional travel |
| Specialist care | 30+ miles |
| Substance treatment | 40+ miles from closed hospital |
| Supermarket (food desert) | >10 miles |
Vehicle Dependency#
| Factor | Impact |
|---|---|
| Car essential for employment | Near-universal in rural areas |
| Healthcare access without vehicle | Severely compromised |
| Food access without vehicle | Creates food insecurity |
| Cost burden of transportation | Higher as percentage of income |
Belief Systems#
Religious Affiliation#
| Factor | Rural Characteristic |
|---|---|
| Religious affiliation rate | Higher than urban |
| Church attendance | More frequent |
| Faith community as social hub | Central role |
| Protestant Christianity | Predominant |
| Regional variations | Catholic (Northeast), Evangelical (South) |
Values and Worldview (Survey-Based Patterns)#
| Value/Outlook | Rural Tendency |
|---|---|
| Self-reliance | Strongly emphasized |
| Institutional trust | Generally lower |
| Government skepticism | More prevalent |
| Community mutual aid | Highly valued |
| Fatalism vs. agency | Mixed/complex |
| Traditional values | More prevalent |
Lifestyles and Culture#
Health Behaviors#
| Behavior | Rural vs Urban |
|---|---|
| Tobacco use | Higher rates |
| Physical activity (occupational) | Higher |
| Physical activity (recreational) | Lower |
| Preventive care utilization | Lower |
| ER as primary care | More common |
Health Outcomes#
| Metric | Rural Status |
|---|---|
| Heart disease mortality (2019+) | Higher |
| Cancer mortality | Higher |
| Unintentional injury mortality | Higher |
| Stroke mortality | Higher |
| Life expectancy gap | Growing |
Dietary Patterns#
| Factor | Rural Characteristic |
|---|---|
| Fresh produce consumption | Lower (access barriers) |
| Processed food consumption | Higher |
| Food preservation traditions | More common |
| Meat-centered meals | More prevalent |
| Regional food traditions | Strong |
Work and Daily Life#
| Aspect | Rural Pattern |
|---|---|
| Work hours | Often longer, more physical |
| Multiple jobs | Common |
| Seasonal employment | More prevalent |
| Commute distance | Generally longer |
| Informal economy | Significant role |
Summary Comparison Table#
Rural vs. Urban: Key Metrics at a Glance#
| Category | Rural | Urban | Direction |
|---|---|---|---|
| Population | 46.2M (14%) | ~290M (86%) | - |
| Land area | 72% | 28% | - |
| Median household income | ~$52,000 | ~$58,000 | Rural lower |
| Poverty rate | 15.4% | ~12% | Rural higher |
| Bachelor’s degree+ | 23% | 36% | Rural lower |
| Food insecurity | 15.4% | 15.9% | Similar |
| Broadband access (100/20) | 72% | 95% | Rural lower |
| Hospital closures (2005-24) | 193 | Far fewer | Rural crisis |
| Provider shortage areas | 60%+ of HPSAs | - | Rural worse |
| Population growth (2020-24) | ~1% | ~2.6% | Rural slower |
How this article connects to others in Blue Gray Matters.
RHTP-03.01
RHTP Inside HR1
related
Consolidated metrics here provide the quantitative baseline for measuring the policy disruption 3A documents; coverage rates, hospital counts, and food assistance figures are the numbers that shift under OBBBA provisions.
RHTP-11.TD1
Rural Disease Burden Atlas
technical
The rural health baseline data tables here are the reference point against which the disease burden atlas in Series 11 measures clinical disparities.
50-state constraint reference data in Series 3 draws on the census-derived rural population and coverage figures this data table compiles — the constraint reference integrates these baseline metrics with Medicaid exposure and RHTP allocation to produce the state constraint profiles driving cluster assignments.
Cross-population intersectionality analysis in Series 9 uses the regional and state-level population distributions documented here as the geographic frame for compound disadvantage mapping.
Policy earthquake impact projections in Series 12 are calibrated against the baseline coverage rates, hospital counts, and provider ratios this data table establishes.
Sources cited in this article.
- Chartis Center for Rural Health. "The Rural Health Safety Net Under Pressure: Rural Hospital Vulnerability." *Chartis Group*, February 2024.
- Coleman-Jensen, Alisha, et al. "Household Food Security in the United States in 2023." *USDA Economic Research Service*, Economic Research Report No. 325, September 2024.
- Cromartie, John. "Rural America at a Glance, 2024 Edition." *USDA Economic Research Service*, Economic Information Bulletin No. 278, November 2024.
- Federal Communications Commission. "Fourteenth Broadband Deployment Report." *FCC*, January 2024.
- Feeding America. "Map the Meal Gap 2024." 2024. https://www.feedingamerica.org/research/map-the-meal-gap
- Health Resources and Services Administration. "Designated Health Professional Shortage Areas Statistics." *HRSA Data Warehouse*, 2024.
- Kaiser Family Foundation. "Status of State Medicaid Expansion Decisions." *KFF*, 2024.
- National Center for Education Statistics. "Status of Education in Rural America." *NCES 2023-006*, U.S. Department of Education, 2023.
- Thomas, Sharita R., et al. "A Comparison of Closed Rural Hospitals and Perceived Impact." *North Carolina Rural Health Research Program*, Cecil G. Sheps Center, 2024.
- U.S. Census Bureau. "American Community Survey 5-Year Estimates, 2019-2023." 2024.
- USDA Economic Research Service. "Rural Classifications: Overview." 2024. https://www.ers.usda.gov/topics/rural-economy-population/rural-classifications/